Robotic fastening system

• US 9,192,395 B2
• Filed: 05/07/2013
• Issued: 11/24/2015
• Est. Priority Date: 03/20/2002
• Status: Expired due to Fees

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M
• Primary Examiner(s): WEISBERG, AMY REGINA
• Application Number:
  US13/888,957
• Publication Number:
  US 20130274760A1
• Time in Patent Office: 931 Days
• Field of Search: 606232-233, 606144-148, 606/1, 606/130, 227/19, 128/898, 173 1- 4
• US Class Current: 1/1
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/14 Surgical saws A61B17/1637 takes precedence; tooth saws A61C3/12 ; Accessories therefor
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/1626 Control means; Display units
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 17/8802 Equipment for handling bone cement or other fluid fillers
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 17/885 Tools for expanding or compacting bones or discs or cavities therein A61B17/8805, A61B17/7097 take precedence
• CPC Class Codes: A61B 17/8852 capable of being assembled or enlarged, or changing shape, inside the bone or disc
• CPC Class Codes: A61B 17/8855 inflatable, e.g. kyphoplasty balloons
• CPC Class Codes: A61B 17/8858 laterally or radially expansible inflatable A61B17/8855
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61B 2034/303 specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/3916 : Bone tissue
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/32 : operating autonomously
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 5/0071 : by measuring fluorescence emission
• CPC Class Codes: A61B 6/032 : Transmission computed tomography [CT]
• CPC Class Codes: A61B 90/03 : Automatic limiting or abutting means, e.g. for safety
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/0063 : Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/389 : Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30133 : kidney-shaped or bean-shaped

Abstract

An improved apparatus and method of securing body tissue may be performed with a robotic mechanism. The robotic mechanism may be utilized to tension a suture with a predetermined force and urge a suture retainer toward body tissue with a predetermined force. Ultrasonic vibratory energy may be transmitted to the suture retainer to effect a gripping of the suture by the suture retainer. The body tissue may be secured with a staple. Legs of the staple may be bonded together to secure the staple. The legs of the staple may be bonded together by transmitting ultrasonic vibratory energy to the legs of the staple. A tissue positioning assembly may be used to hold the body tissue in a desired position. Images of the body tissue being secured may be obtained using various known devices including one or more endoscopes, a fluoroscope, a magnetic resonance imaging device, and/or other known imaging devices.

Claims

1. A robotic fastening system comprising:

a robotic mechanism including an adaptive arm configured to position a staple relative to a body portion of a patient;

a robotic arm interface configured to operate the adaptive arm of the robotic mechanism;

a staple having first and second legs;

a fastening member coupled to the adaptive arm, the fastening member having first and second force transmitting portions and configured to secure the body portion with the staple by applying a force from the first and second force transmitting portions to move the first and second legs of the staple toward each other;

at least one of a position sensor configured to indicate a distance moved by the staple and a force measurement device configured to indicate a resistance required to move the staple relative to the body portion; and

a tissue retractor assembly coupled to the robotic mechanism, the tissue retractor assembly including a cannula configured to facilitate insertion of the fastening member through the cannula into a working space inside the patient.

2. The system of claim 1, further comprising a visual readout configured to enable a user to determine a magnitude of tension on the staple.

3. The system of claim 1, wherein the staple is formed of a polymeric material.

4. A robotic fastening system comprising:

a robotic mechanism including an adaptive arm configured to position a staple relative to a body portion of a patient;

a robotic arm interface configured to operate the adaptive arm of the robotic mechanism;

an endoscope coupled to the adaptive arm;

an imaging device configured provide an image, from the endoscope, of the staple relative to the body portion;

a staple having first and second legs;

a fastening member coupled to the adaptive arm, the fastening member having first and second force transmitting portions and configured to secure the body portion with the staple based on a location of tissue determined with the image provided by the endoscope by applying a force from the first and second force transmitting portions to move the first and second legs of the staple toward each other; and

at least one of a position sensor configured to indicate a distance moved by the staple and a force measurement device configured to indicate a resistance required to move the staple relative to the body portion.

5. The system of claim 4, wherein the staple is formed of a polymeric material.

6. A robotic fastening system comprising:

a robotic mechanism including an adaptive arm with an inserter member configured to position a staple relative to a body portion of a patient;

a staple having first and second legs;

the inserter member having a passage extending through at least a portion of the inserter member, the passage being configured to receive the staple in at least a portion of the passage;

a pusher member disposed in at least a portion of the inserter member and configured to move along the passage of the inserter member to urge the staple toward the body portion and apply a predetermined force to the staple to at least one of deflect and bend the first and second legs of the staple; and

a computer coupled to the robotic mechanism, the computer configured to determine the predetermined force applied by the pusher member based on the body portion.

7. The system of claim 6, wherein the staple is formed of a polymeric material.